Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran
Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran
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DOI：
10.1136/jcp.57.1.37
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发表时间：
2004-01-01
影响因子：
3.4
通讯作者：
Fleischer, DE
中科院分区：
文献类型：
--
作者：
Malekzadeh, R;Sotoudeh, M;Fleischer, DE
背景/目标：伊朗西北部的阿尔达比勒省是伊朗胃（主要是贲门）腺癌发病率最高的地区。本研究旨在探讨内镜筛查的可行性，并寻找相关的幽门螺杆菌感染与胃癌前病变。方法：通过简单随机入户调查，在农村和城市地区选择并邀请1105名成年志愿者，他们是Ardabil和Meshkinshahr地区的居民，年龄为40岁及以上。获得知情同意，并进行上消化道视频内窥镜检查，对胃窦、胃体和贲门的所有可见病变和标准部位进行活检。结果：1011名受邀者同意参加，其中男性494名，女性517名，平均（SD）年龄为53.32（10.39）岁。所有受试者对内窥镜检查的耐受性良好； 96.7% 的胃窦和 80.7% 的贲门粘膜活检结果令人满意。至少 89.2% 的受试者的幽门螺杆菌尿素酶检测或组织学结果呈阳性。在 39.3% 的胃窦和 21.9% 的贲门样本中观察到粘膜萎缩的组织学证据。胃窦有或无活动性慢性胃炎、腺上皮反应性异型性、肠上皮化生、不典型增生和癌症分别占胃窦的95.1%、38.0%、8.7%、0.2%和0.3%，心脏活检的85.3%、22.9%、3.8%、0.3%和0.1%。结论：在伊朗阿尔达比勒，上消化道疾病的内窥镜筛查是可行的且耐受性良好。大多数受试者表现出幽门螺杆菌感染。萎缩性胃炎、反应性异型性和肠化生常见于胃窦、胃体和贲门亚位点。
Background/Aims: Ardabil Province, in northwestern Iran, has the highest rate of gastric ( predominantly cardia) adenocarcinoma in Iran. This study aimed to investigate the feasibility of endoscopic screening and to look for associated Helicobacter pylori infection and gastric precancerous lesions.Methods: One thousand one hundred and five adult volunteers, residents of Ardabil and Meshkinshahr, districts, 40 years old and above were selected and invited by a simple random household canvass in rural and urban locations. Informed consents were obtained and upper gastrointestinal video endoscopy was performed to biopsy all visible lesions and standard sites in the antrum, corpus, and cardiaResults: One thousand and eleven of the invited individuals agreed to participate, including 494 men and 517 women, with a mean (SD) age of 53.32 (10.39) years. Endoscopy was well tolerated by all subjects; 96.7% of antral and 80.7% of cardia mucosal biopsies were satisfactory. The urease test or histology for H pylori was positive in at least 89.2% of subjects. Histological evidence of mucosal atrophy was seen in 39.3% of antral and 21.9% of cardia samples. Chronic gastritis with or without activity, reactive atypia of glandular epithelium, intestinal metaplasia, dysplasia, and cancer were found in 95.1%, 38.0%, 8.7%, 0.2%, and 0.3% of antral and 85.3%, 22.9%, 3.8%, 0.3%, and 0.1% of cardiac biopsies, respectively.Conclusion: Endoscopic screening for upper gastrointestinal diseases was feasible and well tolerated in Ardabil, Iran. Most subjects showed H pylori infection. Atrophic gastritis, reactive atypia, and intestinal metaplasia were common in antrum, corpus, and cardia subsites.